How much rates vary
Facilitymedian $5,754 · 10th to 90th $813 to $17,783Professionalmedian $5,248 · 10th to 90th $1,698 to $12,589
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $14,454.40 | Facility | None | $1,698.24 | $1,698.24 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $19,498.45 | Professional | None | $1,698.24 | $1,698.24 | $19,498.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,715.19 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $6,165.95 Typical High $12,882.50 | Professional | None | $1,995.26 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $3,890.45 Typical High $8,128.31 | Professional | 62 · Two surgeons | $1,258.93 | $3,890.45 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $977.24 Typical High $2,041.74 | Professional | 80 · Assistant surgeon | $323.59 | $977.24 | $2,041.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $851.14 Typical High $1,778.28 | Professional | AS · PA/NP assist | $281.84 | $851.14 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,456.54 | Facility | None | $812.83 | $4,168.69 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $6,025.60 | Professional | None | $2,187.76 | $3,388.44 | $6,025.60 |
DeanCare Setting Facility Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $4,265.80 Typical High $5,370.32 | Professional | None | $2,884.03 | $4,265.80 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $5,248.07 Typical High $10,964.78 | Professional | None | $1,862.09 | $5,248.07 | $10,964.78 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,235.94 | Facility | None | $2,089.30 | $2,398.83 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $5,370.32 | Professional | None | $2,398.83 | $4,073.80 | $5,370.32 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,778.28 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,918.31 | Professional | None | $1,621.81 | $3,715.35 | $6,918.31 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $5,248.07 | Professional | None | $2,187.76 | $2,187.76 | $5,248.07 |
Security Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Security Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,549.93 Typical High $12,589.25 | Professional | None | $7,943.28 | $9,549.93 | $12,589.25 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,128.31 | Professional | None | $1,548.82 | $4,570.88 | $8,128.31 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $851.14 Typical High $9,772.37 | Professional | 52 · Reduced service | $851.14 | $851.14 | $9,772.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $3,890.45 | Professional | 53 · Discontinued | $338.84 | $338.84 | $3,890.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $14,791.08 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $2,951.21 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $2,951.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $1,949.84 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $1,949.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $13,803.84 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $13,803.84 |
Where Wisconsin sits
The same service costs 6.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 2nd of 51
$5,248
AK $6,607TX $977
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.